Four priorities to transform mental health care

By: Kim Keck , President and CEO at Blue Cross Blue Shield Association

In our communities, our workplaces and in many of our homes, mental health struggles are an increasingly prevalent part of American life. This year, nearly 1 in 5 adults in the U.S.–almost 50 million people–will deal with a mental health condition. Worse still, half are suffering in silence, without receiving the treatment they need. Blue Cross and Blue Shield companies are committed to changing this.

This Mental Health Awareness Month, we’re sharing our four priorities to transform mental health care—informed by our data and experience of insuring 1 in 3 Americans:

1. First, we must address the mental health crisis among youth. Isolation and uncertainty over the past two years, in addition to many other societal stressors, have levied a heavy toll, especially on our nation’s children, adolescents and young adults. Last year, more than half of young adults ages 18-21 reported symptoms of anxiety or depression. It’s critical that we work from all angles to better screen and diagnose mental illness among young people and support them with early intervention. This requires education, training and support, both inside and outside the traditional realms of health care. For example, Blue Cross Blue Shield of Alabama is elevating youth mental health services in educational settings. This includes piloting a classroom-based needs assessment tool and delivering de-escalation training to transform how schools respond to students in crisis.
2. Next, we need to broadly increase access to equitable mental health care. Too few Americans possess sufficient access to mental health services and qualified mental health professionals. Research shows a staggering 77% of U.S. counties are currently underserved. We need to ensure that all patients in crisis get access to the care they need, when they need it, no matter where they live or their racial, ethnic or linguistic background. A few ways to close these gaps are by expanding access to telehealth services and leveraging non-clinical personnel such as peer support specialists. It is also important for intermediaries like employers to prioritize full health and support those in need with mental health resources embedded in employer assistance programs. Blue Cross Blue Shield of Massachusetts and Blue Shield of California have made strategic investments aiming to solve the demand surplus and supply deficit, including funding Brightline, a company that provides virtual behavioral health care to 50 employers and covers more than 24 million health plan lives, with plans to reach over 50 million health plan lives in 2022.
3. Third, we need better integration of care. Data show that when physical and mental health care are fragmented, diagnoses are often missed and conditions go untreated. Integration comes from working side-by-side as a team. When we take a team-based approach, we reduce the burden on patients and caregivers, reduce costs and improve outcomes. To bring these findings to life, Arkansas Blue Cross and Blue Shield is funding Masters of Social Work programs at three local universities. Upon graduation, emerging professionals will work in primary care practices. It is also funding the HealthySteps program to increase the number of mental health providers that work in pediatric primary care facilities. 
4. Finally, we must confront the unacceptable inequities in mental health among historically marginalized communities as a core function of everything we do. Research that we will soon publish shows Black and Hispanic Americans have 31% and 39% lower diagnosis rates of major depression, respectively, as compared to white Americans. This indicates significant under-diagnosis and unnecessary suffering. While I am optimistic about our ability to provide relief, we cannot heal what we have not identified.
   
   Blue Cross and Blue Shield companies are working to unravel these disparities, destigmatize the need for help and improve diagnoses among marginalized communities. In response to both the mental health and maternal health crises, in partnership with Medicaid, Horizon Blue Cross Blue Shield of New Jersey is working with doctors to improve the ways they evaluate postpartum depression in Black women, since symptoms can vary based on lived experiences and cultural backgrounds. University of Chicago researchers are guiding the team’s work, using evidence-based strategies to dig into the root causes behind disparities in postpartum depression and other mood disorder diagnosis rates, and map out the best ways to intervene.

Considering the complexity of these challenges, transforming mental health must be a collective effort. It will require business leaders, policymakers, researchers and community leaders to act with a sense of urgency while rigorously prioritizing the focus areas that will have the biggest impact: youth mental health, access, care integration and equity.

If we collaborate to solve the hardest problems, I believe we can meaningfully improve outcomes for millions of Americans and reverse the mental health crisis we face today. 

Blue Cross Blue Shield of Alabama, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, Arkansas Blue Cross Blue Shield and Horizon Blue Cross Blue Shield are independent licensees of the Blue Cross Blue Shield Association.